Mazzarino Melissa, Kerr Debra, Morris Meg E
Centre for Chronic Disease Prevention and Management, College of Health & Biomedicine, Victoria University, St Albans, Victoria, Australia.
Centre for Quality and Patient Safety Research (QPS), School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
J Bodyw Mov Ther. 2018 Apr;22(2):411-417. doi: 10.1016/j.jbmt.2017.05.015. Epub 2017 May 31.
Little is known about recommendations for safe and appropriate instruction of Pilates exercises to women during pregnancy. The aim of this study was to examine Pilates practitioners' perspectives regarding Pilates program design for pregnant women. We also sought to elucidate their views on the potential benefits, restrictions and contraindications on Pilates in pregnancy.
A cross-sectional survey was performed. Pilates practitioners were invited to participate via email. Participants were surveyed about their experience and views on: screening processes in alignment with The American College of Obstetricians and Gynecologists (ACOG) (2002) guidelines; (ii) optimal exercise program features and (iii) physical and mental health benefits of Pilates for pregnant women.
The survey was completed by 192 Pilates practitioners from a range of settings. Practitioners reported conducting formal screening (84%) for safety in pregnant women prior to commencing Pilates classes. Most did not routinely seek medical approval from the woman's general practitioner. Divergent views emerged regarding the safety and benefits of Pilates exercises in the supine position. Mixed opinions were also generated regarding the effects of spinal flexion exercises, single-leg stance exercises and breathing manoeuvres. There was little agreement on the optimal frequency or dosage of exercises. Views regarding absolute contraindications to exercise differed from The American College of Obstetricians and Gynecologists (ACOG) (2002) guidelines which cautioned about the dangers of persistent bleeding, premature labour, pre-eclampsia, placental praevia and incompetent cervix. The most frequent reported physical and psychological benefit of Pilates was improving pelvic floor strength (12%) and improved social wellbeing (23%).
The study highlighted wide variations in practice for Pilates exercises with pregnant woman as well as low adherence to clinical practice guidelines. Further evidence is required to advise on appropriate screening and individualized Pilates programming, particularly for women with medical conditions during pregnancy.
对于孕期女性进行安全且合适的普拉提练习指导建议，我们知之甚少。本研究的目的是探讨普拉提从业者对于孕妇普拉提课程设计的看法。我们还试图阐明他们对孕期普拉提的潜在益处、限制和禁忌的观点。
进行了一项横断面调查。通过电子邮件邀请普拉提从业者参与。就以下方面对参与者进行了调查：与美国妇产科医师学会（ACOG）（2002年）指南一致的筛查过程；（ii）最佳锻炼计划特点；（iii）普拉提对孕妇身心健康的益处。
来自不同场所的192名普拉提从业者完成了调查。从业者报告称，在开始普拉提课程之前，会对孕妇进行正式的安全筛查（84%）。大多数人没有常规寻求女性全科医生的医学批准。对于仰卧位普拉提练习的安全性和益处出现了不同观点。对于脊柱屈曲练习、单腿站立练习和呼吸动作的效果也有不同意见。对于锻炼的最佳频率或剂量几乎没有一致意见。关于运动绝对禁忌的观点与美国妇产科医师学会（ACOG）（2002年）指南不同，该指南警告了持续出血、早产、先兆子痫、前置胎盘和宫颈机能不全的危险。普拉提最常报告的身体和心理益处是改善盆底力量（12%）和改善社交幸福感（23%）。
该研究强调了孕妇普拉提练习在实践中的广泛差异以及对临床实践指南的低遵循度。需要进一步的证据来为适当的筛查和个性化普拉提课程提供建议，特别是对于孕期有医疗状况的女性。
